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Alternative Names Return to topAudiometry; Hearing test; Audiography (audiogram)
Definition Return to top
An audiology exam tests your ability to hear sounds. Sounds vary based on their loudness (intensity) and the speed of sound wave vibrations (tone).
Hearing occurs when sound waves are converted into electrical energy, which stimulates the nerves of the inner ear. Eventually the sound travels along nerve pathways to the brain.
Sound waves can travel to the inner ear through the ear canal, eardrum, and bones of the middle ear (air conduction), or through the bones around and behind the ear (bone conduction).
The INTENSITY of sound is measured in decibels (dB):
Usually, sounds greater than 85 dB can cause hearing loss in a few hours. Louder sounds can cause immediate pain, and hearing loss can develop in a very short time.
The TONE of sound is measured in cycles per second (cps) or Hertz:
The normal range of human hearing is about 20 Hz - 20,000 Hz. Some animals can hear up to 50,000 Hz. Human speech is usually 500 - 3,000 Hz.
How the Test is Performed Return to top
The first steps are to see whether you need an audiogram. The specific procedures may vary, but they generally involve blocking one ear at a time and checking your ability to hear whispers, spoken words, or the sound of a ticking watch.
A tuning fork may be used. The tuning fork is tapped and held in the air on each side of the head to test the ability to hear by air conduction. It is tapped and placed against the mastoid bone behind each ear to test bone conduction.
Audiometry provides a more precise measurement of hearing. To test air conduction, you wear earphones attached to the audiometer. Pure tones of controlled intensity are delivered to one ear at a time. You are asked to raise a hand, press a button, or otherwise indicate when you hear a sound.
The minimum intensity (volume) required to hear each tone is graphed. An attachment called a bone oscillator is placed against the bone behind each ear (mastoid bone) to test bone conduction.
How to Prepare for the Test Return to top
No special preparation is needed.
How the Test Will Feel Return to top
There is no discomfort. The length of time varies. An initial screening may take about 5 to 10 minutes. Detailed audiometry may take about 1 hour.
Why the Test is Performed Return to top
This test can detect hearing loss at an early stage. It may also be used when you have difficulty hearing from any cause.
Common causes of hearing loss include:
Normal Results Return to top
What Abnormal Results Mean Return to top
There are many different kinds and degrees of hearing loss. In some types, you only lose the ability to hear high or low tones, or you lose only air or bone conduction. The inability to hear pure tones below 25 dB indicates some hearing loss.
The amount and type of hearing loss may give clues to the cause and outlook.
The following conditions may affect test results:
Risks Return to top
There is no risk.
Considerations Return to top
There are many different hearing function tests. In simple screenings, the health care provider will make a loud noise and watch to see if it startles you. Detailed screenings include brainstem auditory evoked response testing (BAER). This test uses an electroencephalogram to detect brain wave activity when sounds are made.
A newer hearing test called otoacoustic emission testing (OAE) can be used in very young children (such as newborns) or when standard tests do not produce reliable results.
References Return to top
Cummings CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 4th ed. St Louis, Mo; Mosby; 2005:3466-3479.
Kerschner JE. Neonatal hearing screening: To do or not to do. Pediatr Clin North Am. June 2004; 51(3): 725-36, x.Update Date: 10/10/2008 Updated by: Alan Lipkin, MD, Otolaryngologist, Private Practice, Denver, Colorado. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.